Category Archives: Bulimia Nervosa

Your Brain on a Diet

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In my last post, New Year’s Resolution: Ditch the Diet, I explained that dieting is ineffective form of weight regulation for most people, is a risk factor for developing an eating disorder and can wreak havoc on our self-esteem.

In this post I am excited to share Dr. Sandra Aamodt’s TEDS talk-the neuroscience behind why dieting doesn’t work.

Dr. Sandra Aamodt, a neuroscientist, explains how our brains regulate our body weight like a thermostat which makes dieting an ineffective way to lose weight.

Dr. Aamodt’s talk starts out a little dry and slow, but hang in there.  She offers compelling research on how to improve your health regardless of body weight, throws in humor and her personal experience with dieting.  Which had me laughing and crying by the end.

It is definitely worth 12 or so minutes of your time.

New Year’s Resolution: Ditch the Diet

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New Year's ResolutionYes, that is right.  Set a New Year’s Resolution NOT DIET in 2015 (or really ever again).

Why you ask?  I will give you five good reasons:

1.  Dieting doesn’t work for long-term weight regulation.  Scientists don’t have any good data that shows dieting works consistently in reducing weight, long-term, in populations of people.

2. Dieting can lead to weight gain.  Dieting can produce short-term weight loss, but more often than not, it leads to regaining of lost weight and sometimes even more.  Some clinicians argue that the losing/gaining weight cycle (sometimes referred to as weight cycling) is what causes health problems in overweight and obese individuals (Versus elevated body weight.).

3.  Dieting is a known risk factor for developing an eating disorder.  The causes of eating disorders are very complex and researchers have identified several risk factors for developing an eating disorder which include dieting, temperament, gender, etc.  Not to say that all people who diet will develop an eating disorder, but it may increase your risk.

4.  Dieting can make us feel a little crazy.  At the start of a diet there is promise that the diet will bring control over eating (and sometimes our lives).  But, ever notice when you are dieting that you spend more time thinking about food?  Or that when your dieting you begin to feel very uncomfortable around food?  Maybe you avoid certain social situations because you are dieting.  I would argue that dieting leads to more preoccupation with food, weight/shape which leaves less head space to think about other things.

Additionally, when we aren’t able to follow our diet (Not because of laziness or lack of will power by the way, see 1#.) it can lead to an increase in feelings of shame and failure. These feelings can often drive us further from self-care and in some people it can lead to OVEREATING.

To learn more about the psychological effects of food restriction click here.

5.  Dieting doesn’t equal improved health. See #1, #2, #3, #4

In my next few posts I will discuss further reasons why dieting doesn’t work and what one might do as an alternative to dieting.

5 Things About Binge Eating Disorder Perhaps You Didn’t Know

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At the Austin Eating Disorder Specialists  professional group  meeting in November I had the pleasure of hearing Dr. Susan C. Mengden, the co-executive director of the Eating Disorder Center of San Antonio, present on “Treating Binge Eating Disorder in an Intensive Outpatient Setting”.  She offered some good reminders about Binge Eating Disorder that I would like to share:

1.  Binge eating disorder (BED) is the most common type of eating disorder.  It affects men and woman almost equally.  External risk factors for BED, according to Dr. Mengden include physical/sexual abuse, bullying, family dynamics and poor self-esteem and/or shyness.

2.  Up to 30% of those seeking weight loss services most likely meet the criteria for binge eating disorder. Weight loss or weight loss surgery does not cure binge eating disorder.  Before any type of weight loss is considered the binge eating disorder must be dealt with or weight loss is almost impossible.  If you feel that you may have binge eating disorder, consider getting screened for it and don’t try to diet your way out of it—most likely dieting will make the BED worse.

3.  Anger and anxiety is are the predominant emotions that lead to binge eating.  That is, anger and anxiety are the emotions that most often trigger binge eating episodes.  I like to remind clients that eating disorders are functional.  That is, there is some benefit that the sufferer is getting out of doing the eating disorder behaviors.  Eating disorders are not due to lack of will power on the sufferers’  part.  Overeating helps, short-term, soothe uncomfortable emotions.

4. Restriction is often common in binge eating disorder.  Usually with those who struggle with binge eating have chronically dieted and tend to diet (or restrict food) on a regular basis.  Restriction is well documented to exacerbate binge eating (Can’t mess with biology!) and food restriction can lead to increase anxiety (see #2).

5.  Body dissatisfaction is present in almost all cases of binge eating disorder regardless of body size.  Body dissatisfaction and the drive for thinness usually leads to dieting.  Improved body image is needed to help in the recovery from BED.

To learn more about Binge Eating Disorder go to:

Binge Eating Disorder Association

National Eating Disorder AssociationContinue reading→

An ED Professional’s Opinion on FDA’s Requiring Calories

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Food LabelingI feel so so very torn about the FDA’s new requirement of putting calorie counts on menus of restaurants, movie theaters, amusement parks, etc…..I do not recommend people tracking their calories to regulate their weight or for health reasons as it gets us away from eating intuitively.

Calorie counting promotes dieting behavior (which we know doesn’t work for long term weight regulation).  Dieting is a known risk factor for developing an eating disorder (ED).  And calorie counting may exacerbate eating disorder symptoms in someone who is in recovery from an ED.

And to my knowledge, the jury is still out if putting calories on menus is helpful in improving overall health.

On the other hand, I do think we need to improve the quality of our food in this country in order to promote the health of our nation and our environment.  I wonder if requiring food establishments to be transparent about calories, if it would force the food companies to improve overall food quality???

I am the first one to admit I don’t have the answer to our dilemma, but I do feel like Life Time Fitness may be onto something here…  In their magazine, Experience Life, in their recipe section they do not include nutrition information (calories, carbohydrate grams, etc.) . Unlike other popular “health magazines”.

Not only does Experience Life magazine exclude nutrition information of their recipes, they go the extra mile and provide a health promotion message instead.  Here is their explanation as it appears in their recipe section of the magazine:

“Why No Numbers?

Readers sometimes ask why we don’t publish calories, carb and fat counts with our recipes.  We believe that if you’re eating primarily whole, healthy foods (array of sustainably raised vegetables, fruits, nuts, seed, legumes, meats, fish, egg, whole-kernel grains, and healthy fats and oils), you really don’t need to stress about the numbers (which are often inaccurate or misleading anyway).  We prefer to focus more on food quality and trust our bodies to tell us what we need.”

Sounds good to me.  Folks what do you think????

Eating Disorder Prevention: Lessons learned at NEDA

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NEDA Conference

Last week I attended the National Eating Disorder Association’s (NEDA) annual conference in San Antonio.  I have attended many professional conferences on eating disorders, but NEDA’s was unique.   Attendees and presenters included professionals who treat clients with eating disorders, eating disorder prevention specialists and those who have been affected by eating disorders (individuals that are at different points in their recovery & family and friends of loved ones with an eating disorder).

I attended several different sessions ranging from binge eating disorder, media & eating disorders, eating disorders in midlife to name a few.  I wanted to share the with you two important points about eating disorder prevention that I learned:

1.  Resources (money, people) are the largest barrier to implementing eating disorder prevention programs.  There are genetic risk factors that contribute to the development of eating disorders (being female is one example).   And there are modifiable risk factors such as body dissatisfaction and dieting.

Eating disorder prevention programs obviously target the modifiable risk factors in order to prevent some eating disorders.  An example of an evidence based eating disorder prevention program includes: The Body Project  which aims to reduce the drive for thinness in adolescent and college age females.

Want to become more involved in the prevention of eating disorders?  Check out these resources: National Eating Disorder Association  and Eating Disorders Coalition .

2.  Obesity and eating disorder prevention programs could be combined to help reduce eating disorders and help improve health.  While there are plenty of obesity prevention programs in schools and in other public and private health arenas, eating disorder prevention is rarely included.  As I reflect on my own community here in Austin, I am not aware of obesity prevention program that also include an eating disorder prevention component.

Could the “war on obesity*” cause unintentional harm–exacerbate eating problems (including weight regulation) and eating disorders in some people?   Most likely yes.  Let’s take a look at caloric restriction (dieting) which is commonly promoted to help reduce obesity.  Dieting is linked with an increase risk of eating disorders in youth (Haines et al 2010, 2007; Field et al 2003).  Dieting has been linked with an increase in binge eating and can increase the risk of weight gain.  Furthermore, there is little to no evidence that dieting works to regulate weight over ones lifespan in the obese population.

In the spirit of “do no harm”-obesity and eating disorder prevention programs should be developed and executed together.  Prevention programs that promote good nutrition while allowing for a variety of foods, family meals, fun physical activity, promotion of size acceptance, positive body image, etc.  mostly like help with weight regulation and help prevent some eating disorders. Prevention programs should discourage dieting and weight shaming.

 *There are so many things that make me uncomfortable with the “war on obesity”.  I would need to write a whole other blog post to list all the injustices and wrong information associated with the “war on obesity”.  I use the term here “war on obesity” in this post because, unfortunately, it is familiar language in our culture.  To read more info about myths associated with obesity and the ” war on obesity” please check out Health at Every Size.  To learn more about weight stigma click here.

Weight Stigma Awareness Week

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BEDAIt is coming September 22-26th, 2014…Weight Stigma Awareness week sponsored by The Binge Eating Disorder Association!  According to the on-line Merriam-Webster dictionary stigma is defined as “a set of negative and often unfair beliefs that a society or group of people have about something”.

Weight stigma is wide spread through our culture.  It shows up as bullying, verbal assaults and exclusion to name a few.  Weight prejeduce can arise in areas such as employment/occupation, education and health/mental health care.

Weight stigma often is internalized by individuals which can lead to shame, hopelessness, isolation, etc.   Studies suggest that weight bias may actually INCREASE the likelihood of obesity, binge eating and staying obese.   According to the Rudd Center for Food Policy and Obesity, family members are one of the biggest sources of weight bias.  In one study of over 2400 overweight and obese women, 62% of the study participants reported that on multiple occasions they had been stigmatized by their families because of their body weight.

Ways to Reduce Weight Stigma

1.  Get educated on the complexities and causes of obesity.  It is not as easy as calories in and calories out.

2.  Understand that improving ones health can include a multitude of things, such as eating a nutrient dense foods and exercising, not just being thin.

3.  Challenge bias attitudes.  Speak-up.  Don’t just let gossip or criticism about someone’s body weight go unchallenged.

4.  Treat people of all sizes with fairness.

5.  Support media sources such as magazines, TV programs, blogs, etc. that focus on size acceptance vs. fat bashing.

6.  Take stock in your attitude about your own body.

7.  If you are a parent and you think your child may be experiencing weight bias go to the Rudd Center for Food Policy and Obesity.  They have lots of good information about how to talk with your child about it.

The Binge Eating Disorder Association (BEDA) has lots of great on-line event during Weight Stigma Awareness week including featured bloggers, social media events and tool kits.  To learn more click here.